WO2016166448A1 - Vertebral fixation device - Google Patents

Vertebral fixation device Download PDF

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Publication number
WO2016166448A1
WO2016166448A1 PCT/FR2016/050799 FR2016050799W WO2016166448A1 WO 2016166448 A1 WO2016166448 A1 WO 2016166448A1 FR 2016050799 W FR2016050799 W FR 2016050799W WO 2016166448 A1 WO2016166448 A1 WO 2016166448A1
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WO
WIPO (PCT)
Prior art keywords
head
orifice
screw
band
rod
Prior art date
Application number
PCT/FR2016/050799
Other languages
French (fr)
Inventor
Régis LE COUËDIC
Denis Pasquet
Original Assignee
Implanet
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Implanet filed Critical Implanet
Priority to EP16718436.5A priority Critical patent/EP3282980B1/en
Priority to CA2979956A priority patent/CA2979956C/en
Priority to ES16718436T priority patent/ES2926581T3/en
Priority to AU2016250056A priority patent/AU2016250056B2/en
Priority to KR1020177029183A priority patent/KR102550609B1/en
Priority to CN201680022270.XA priority patent/CN107530113B/en
Priority to JP2017554081A priority patent/JP2018511433A/en
Priority to US15/565,733 priority patent/US10420590B2/en
Publication of WO2016166448A1 publication Critical patent/WO2016166448A1/en
Priority to HK18102840.8A priority patent/HK1243301A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7043—Screws or hooks combined with longitudinal elements which do not contact vertebrae with a longitudinal element fixed to one or more transverse elements which connect multiple screws or hooks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices
    • A61B17/7067—Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor

Definitions

  • the present invention relates to a vertebral anchoring system comprising two anchoring parts each comprising a pedicle element adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element.
  • intervertebral discs may be subject to compaction, herniated disc or intervertebral degenerative arthritis.
  • a first technique is to replace the damaged disc with an intervertebral disk prosthesis. Such a replacement is difficult to perform by the surgeon and presents a risk of uncoupling under the effect of significant shear forces that are exerted especially when the prosthesis is in the maximum bending position.
  • a second technique is to perform an intervertebral fusion, an operation to merge the two vertebrae adjacent to the damaged disc. There is then blockage of the degradation due to the removal of any mobility between the two vertebrae concerned.
  • Anchoring devices are known (FR 2 913 330) made by assembling two anchoring parts each comprising a pedicle nail and interconnected by a rigid connection.
  • the present invention aims to overcome these disadvantages and to provide a system, a part and a method of vertebral anchoring better than those previously known to the requirements of the practice, in particular in that it allows a greater flexibility, in that it avoids any intrusive element in a weakened vertebra bone if a solid vertebra exists next to the damaged vertebra, and in that it has a good solidity and for a low cost and / or less than with the devices of the prior art.
  • the invention proposes in particular a vertebral anchoring system comprising two anchoring parts each comprising a pedicle element adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element, characterized in that the connecting element is a flexible band, in that the pedicle elements are screws, in that each anchoring piece comprises a fixing head on a rod integral with adjustable locking means of the flexible band in tension relative to the head and in that it comprises two rods corresponding to said fixing heads.
  • the idea of the system is to control the movements of the degraded vertebra with respect to the more solid adjacent vertebra, by a connection on the spinous vertebrae of the top or bottom vertebra (on its apophysis) by tensioning both sides of the band.
  • the jamming of the braid or band by the blocking means will be able to allow the longitudinal path of it by reproducing what the ligaments of the column do naturally.
  • one or more of the following provisions are also and / or in addition:
  • the fastening head of the anchor is secured to a ring which is provided with locking means;
  • the fixing head comprises a cup-shaped body traversed laterally by the rod perpendicular to the pedicle screw and provided with an internal thread in its upper part, fixing the rod by means of a compression screw, and the ring comprises a first through hole clipping by deformation on the upper periphery of the fixing head, a second lateral orifice; passing through the band and a third insertion hole means for locking the band in the ring;
  • the fastening head comprises a cylindrical upper portion or a cylindrical portion of a first diameter, the first orifice being cylindrical with a diameter complementary to the first diameter with which it is arranged to cooperate with friction before screwing the compression screw and with which it is arranged to lock when tightening said screw.
  • This blockage comes from the widening or removal of the walls of the internal thread of the upper part of the head due to the compression exerted by the head of the compression screw itself on its edges.
  • the head comprises an upper part provided with a groove or a retaining rib and the first through-orifice of the ring is provided with a rib or a groove of corresponding shape arranged to be embedded in force; in the other ;
  • the locking means comprise a holding part insertable into the third hole of the ring, the holding part being at least partly in the form of crushable wedge, blocking the band passing through the second orifice;
  • the retaining piece has a tuning fork-shaped cross-section whose branches comprise external non-return teeth and whose handle has a rounded end, and the third orifice has lateral walls provided with non-return teeth complementary to that of the retaining piece and a bottom of complementary shape to that of the end of the handle, wedging the band between the two;
  • the pedicle screw has a round or oblong end rotatably mounted in rotation in the lower part of the head and the head comprises a connecting structure between the cylindrical wall of the rod and said screw end.
  • the invention also relates to an anchoring piece as described above. It also relates to an anchoring method implementing a system as described above.
  • a vertebral anchoring method for securing two vertebrae adjacent to each other in which two pedicle screws are screwed into the pedicles opposite a vertebra, a rod is slipped through a fixing head of each screw on said rod, and screw a pressure screw on the rod through the upper part of the head, characterized in that before screwing on the pressure screw, a ring is clipped on the upper periphery of each head, comprising a first through hole which can be clipped by deformation on the said upper periphery and comprising a second lateral orifice through which a band passes through and a third orifice insertion of band locking means on said fixing head, placing the flexible band on the adjacent vertebra and in the locking means of each fixing head, blocking said band on a head and starting to put said band flexible in tension pulling the other side, then we put all the tension before definitively block the band relative to the remaining head.
  • Figure 1 is an axionometric perspective view of an anchor according to a first embodiment of the invention.
  • FIG. 1A is a sectional view according to I A -I A of FIG. 1B is a sectional view according to I B - I B of Figure 1.
  • FIG. 1C is a partial sectional view of the type of the section according to I B -I B , of a variant of the part of FIG.
  • Figure 2 is a perspective view of the ring of the part of Figure 1.
  • FIG. 3 schematically illustrates, in plan view, the anchoring system using two anchoring parts according to FIG. 1, two rods and the flexible band in tension around the apophysis of a vertebra.
  • FIG. 4 is a perspective view of a system comprising two anchoring parts according to the embodiment of the invention more particularly described here, in position on two adjacent vertebrae. Note that it has been shown here that a pedicle fixation screw rod, each stem must of course include several to block the movement of at least two adjacent vertebrae.
  • Figure 1 shows an anchoring piece 1 comprising a pedicle screw 2 adapted to be screwed into a vertebra pedicle (not shown).
  • the part comprises a fixing head 3 on a rod 4 secured to means 5 of adjustable locking of a flexible band 6 in tension.
  • the strip 6 is flat, for example braided polyester 1 to 3 mm thick and 6 mm wide.
  • the locking means 5 comprise a ring 7 integral with the head 3, which comprises a body 8 made of hollow cup shape pierced in its lower part or bottom 9 to let the pedicle screw 2, and has two lateral notches 10, open upwards, lateral passage of the rod 4 which is embedded therein.
  • the body 8 for example titanium, is cylindrical and comprises a rounded bottom and a cylindrical inner recess 12 for passage and locking in the axial direction of the screw.
  • Its upper part 13 comprises an internal tapping 14 for fixing the rod, introduced into the lateral notches 10, by a compression screw 15 which thus compresses the rod on the head 16 of the pedicle screw 2.
  • This comprises a screw body 17 provided with a screw thread known per se.
  • the head 16 of the screw (see Figure 1B) is provided with a notch 18 for screwing by a tool. It is partially spherical and abuts on the bottom 11 of the cup of the body 8 of the attachment head 3 with which it cooperates with friction by rotation and in longitudinal stop.
  • the ring 7 (see also FIG. 2) is a piece, for example made of titanium, of cross-section in keyhole shape, with a first cylindrical portion and a second parallelepipedal portion 21 of smaller width than the diameter, or substantially parallelepipedic.
  • the first cylindrical (or substantially cylindrical) portion is provided with an internal cylindrical bore 22 or first orifice comprising a narrowed upper portion 23 forming a locking angle in axial displacement with the top 24 of the fixing head.
  • the internal bore 22 cooperates frictionally in cylinder / cylinder contact with the external surface of the cylindrical upper part 13 of the body 8.
  • the head of the screw 15 being designed to, one carries out a slight expansion of the volume which it occupies during the tightening, for example of the order of 0.2 mm, which deforms in lateral compression the bore of the fastener, which blocks any movement of the ring relative to the fastener.
  • FIG. 1C shows another embodiment where the first orifice 22 of the ring comprises a rib forcefully snapped into a corresponding groove or groove.
  • the ring 7 comprises a second orifice 25, lateral, through, through the strip 6 (vertical slot-shaped width and thickness a little larger (for example with a clearance of 1 mm) than Band 6 to allow for easy passage.
  • the ring 7 further comprises a third orifice 26 crossing the portion 21 perpendicular to the second orifice 25.
  • the portion 21 comprises a first part 27 (see Figure 1A) parallelepiped including anti-return teeth
  • the means 5 for blocking the band 6 furthermore comprise a retaining piece 32 in the form of a tuning fork whose branches are crushable and / or insertable while deforming in the third orifice 26.
  • the piece 32 comprises a cross-section (see FIG. 1A) in the shape of a tuning fork having two branches 33 and 34 separated by a recess 35, themselves provided on their outer faces facing internal lateral faces.
  • the piece 32 also comprises a protruding tongue forming a handle 37 end of the tuning fork which is inserted into the second portion 30 of the orifice to come jam the strip 6 between it and the side edges 38 and the bottom 39 of said second part when the part 32 is completely embedded in the third orifice 26.
  • FIGS. 3 and 4 illustrate the anchoring system according to the embodiment of the invention more particularly described here, using two anchoring pieces 1, 1 'in the two opposite pedicles 40 and 41 of the vertebra 42, each piece being provided with screws 2, 2 'and fixed on the rods 4, 4' by means of the compression screws 15, 15 '.
  • the band 6 is blocked on both sides by the means 5, 5 'of locking and is embedded in 43 on the epiphysis 44 of the vertebra 45 ( Figure 4).
  • the surgeon who wants to relieve the intervertebral disk 47 between the vertebra 42 (solid) and the vertebra 45 (fragile) begins by fixing the pedicle screws previously fitted with their head. fixation in the pedicles 40 and 41 of the vertebra 42, and this in a manner known per se, by screwing said screws through the heads, by means of a screw or tool that attacks the notch 18.
  • the dimensions of the elements are designed to wedge the band in the recess formed by the second portion 30 of the third orifice irremovably and calculated to the scope of the skilled person.
  • the surgeon then stretches the band 6 with a known type of tool by pulling on the end portion 6 '' through the still unrestrained blocking means 8 ', the fixation head 3' having, for its part, been locked onto the rod 41 by screwing the compression screw 15 '.
  • the present invention is not limited to the embodiments more particularly described. On the contrary, it encompasses all the variants and in particular those in which the locking means are different, those where the pedicle screws are double-threaded or those where the rings are snapped onto the fixing head by means of cone / cone contact. for example with a taper angle of the Morse taper type and with a deformable locking tab at the bottom.

Abstract

The invention relates to a vertebral fixation system comprising two fixation parts (1) which each have a pedicular element (2) that can be engaged in a vertebral pedicle and are connected to each other by a connecting element. The connecting element is a flexible strip (6), the pedicular elements are screws, and each fixation part comprises a fixation head (3) on a rod (4) secured to means (5) for adjustably locking the flexible strip under tension in relation to the head.

Description

SYSTEME ET PIECE D'ANCRAGE VERTEBRAL  SYSTEM AND PIECE OF VERTEBRAL ANCHORAGE
La présente invention concerne un système d' ancrage vertébral comprenant deux pièces d' ancrage comportant chacune un élément pédiculaire propre à être engagé dans un pédicule de vertèbre et reliées l'une à l'autre par un élément de liaison. The present invention relates to a vertebral anchoring system comprising two anchoring parts each comprising a pedicle element adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element.
Elle concerne également les pièces d'ancrage proprement dites et un procédé d' ancrage vertébral pour solidariser deux vertèbres adjacentes entre elles .  It also relates to the anchoring parts themselves and a vertebral anchoring method for securing two vertebrae adjacent to each other.
Elle trouve une application particulièrement importante bien que non exclusive dans le domaine de la consolidation de la colonne vertébrale en cas de lésion, et plus particulièrement lorsque l'une des vertèbres est de mauvaise qualité, par exemple due à 1' ostéoporose ou à un accident.  It finds a particularly important application although not exclusive in the field of the consolidation of the spine in case of injury, and more particularly when one of the vertebrae is of poor quality, for example due to osteoporosis or an accident. .
On sait que les disques intervertébraux peuvent être l'objet de tassement, d'hernie discale ou de dégénérescence arthrosique intervertébrale.  It is known that intervertebral discs may be subject to compaction, herniated disc or intervertebral degenerative arthritis.
Pour soulager les patients, il existe alors des techniques nécessitant une intervention chirurgicale.  To relieve patients, there are then techniques requiring surgery.
Une première technique consiste à remplacer le disque endommagé par une prothèse de disque intervertébral. Un tel remplacement est délicat à effectuer par le chirurgien et présente un risque de désolidarisation sous l'effet des forces de cisaillements importantes qui s'exercent notamment lorsque la prothèse est en position de flexion maximale. Une deuxième technique consiste à réaliser une arthrodèse intervertébrale, opération permettant de fusionner les deux vertèbres adjacentes au disque endommagé. Il y a alors blocage de la dégradation du fait de la suppression de toute mobilité entre les deux vertèbres concernées. A first technique is to replace the damaged disc with an intervertebral disk prosthesis. Such a replacement is difficult to perform by the surgeon and presents a risk of uncoupling under the effect of significant shear forces that are exerted especially when the prosthesis is in the maximum bending position. A second technique is to perform an intervertebral fusion, an operation to merge the two vertebrae adjacent to the damaged disc. There is then blockage of the degradation due to the removal of any mobility between the two vertebrae concerned.
C'est une amélioration de cette technique qui est l'objet de la présente l'invention.  It is an improvement of this technique which is the subject of the present invention.
On sait qu'une telle technique implique l'utilisation d'un dispositif de stabilisation des deux vertèbres comportant des vis destinées à être vissées dans les vertèbres et solidarisées entre elles par un organe rigide de liaison. Il est ainsi possible d'éviter que des contraintes mécaniques trop importantes ne soient appliquées au disque intervertébral .  It is known that such a technique involves the use of a device for stabilizing the two vertebrae comprising screws intended to be screwed into the vertebrae and secured together by a rigid connecting member. It is thus possible to avoid excessive mechanical stresses being applied to the intervertebral disc.
Mais cette technique présente des inconvénients nécessitant en particulier de visser dans les vertèbres ce qui est une opération parfois impossible si ces dernières sont en mauvais état et/ou insuffisamment larges au niveau de la fixation.  But this technique has disadvantages requiring in particular to screw in the vertebrae which is an operation sometimes impossible if the latter are in poor condition and / or insufficiently large at the fixation.
On connaît (FR 2 913 330) des dispositifs d'ancrage réalisés par l'assemblage de deux pièces d' ancrage comportant chacune un clou pédiculaire et reliées entre elles par une liaison rigide.  Anchoring devices are known (FR 2 913 330) made by assembling two anchoring parts each comprising a pedicle nail and interconnected by a rigid connection.
Un tel système qui assure une bonne stabilité dans l'os dégradé présente cependant l'inconvénient d'un montage compliqué, les clous pédiculaires pouvant de plus présenter des inclinaisons incompatibles du fait de la configuration de la vertèbre. La présente invention vise à pallier ces inconvénients et à fournir un système, une pièce et un procédé d' ancrage vertébral répondant mieux que ceux antérieurement connus aux exigences de la pratique, notamment en ce qu'elle permet une plus grande flexibilité, en ce qu'elle évite tout élément intrusif dans un os de vertèbre fragilisé pour peu qu'une vertèbre solide existe à côté de la vertèbre abimée, et en ce qu'elle présente une bonne solidité et ce pour un coût faible et/ou moindre qu'avec les dispositifs de l'art antérieur. Such a system which provides good stability in the degraded bone, however, has the disadvantage of a complicated assembly, the pedicle nails may also have incompatible inclinations due to the configuration of the vertebra. The present invention aims to overcome these disadvantages and to provide a system, a part and a method of vertebral anchoring better than those previously known to the requirements of the practice, in particular in that it allows a greater flexibility, in that it avoids any intrusive element in a weakened vertebra bone if a solid vertebra exists next to the damaged vertebra, and in that it has a good solidity and for a low cost and / or less than with the devices of the prior art.
Elle présente également l'avantage d'un maniement aisé permettant sa mise en place facile par le chirurgien .  It also has the advantage of easy handling for easy installation by the surgeon.
Dans ce but l'invention propose notamment un système d' ancrage vertébral comprenant deux pièces d' ancrage comportant chacune un élément pédiculaire propre à être engagé dans un pédicule de vertèbre et reliées l'une à l'autre par un élément de liaison, caractérisé en ce que l'élément de liaison est une bande souple, en ce que les éléments pédiculaires sont des vis, en ce que chaque pièce d'ancrage comporte une tête de fixation sur une tige solidaire de moyens de blocage réglable de la bande souple en tension par rapport à la tête et en ce qu' il comporte deux tiges correspondantes auxdites têtes de fixation .  For this purpose the invention proposes in particular a vertebral anchoring system comprising two anchoring parts each comprising a pedicle element adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element, characterized in that the connecting element is a flexible band, in that the pedicle elements are screws, in that each anchoring piece comprises a fixing head on a rod integral with adjustable locking means of the flexible band in tension relative to the head and in that it comprises two rods corresponding to said fixing heads.
L' idée du système est de contrôler les mouvements de la vertèbre dégradée par rapport à la vertèbre adjacente plus solide, par une liaison sur l'épineuse de la vertèbre du dessus ou du dessous (sur son apophyse) grâce à une mise en tension des deux côtés de la bande. The idea of the system is to control the movements of the degraded vertebra with respect to the more solid adjacent vertebra, by a connection on the spinous vertebrae of the top or bottom vertebra (on its apophysis) by tensioning both sides of the band.
Ici le coincement de la tresse ou bande par les moyens de blocage va pouvoir autoriser le trajet longitudinal de celle-ci en reproduisant ce que font naturellement les ligaments de la colonne.  Here the jamming of the braid or band by the blocking means will be able to allow the longitudinal path of it by reproducing what the ligaments of the column do naturally.
L'amplitude des mouvements va ainsi pouvoir être limitée sans être complètement bloquée, ce qui évite en partie de reporter tous les efforts sur le disque libre adjacent aux vertèbres bloquées en mouvement entre elles, qui autrement engendre le phénomène bien connu d'effet « charnière », risquant cette fois-ci d'endommager le disque adjacent encore en bon état.  The amplitude of the movements will thus be able to be limited without being completely blocked, which partly avoids postponing all efforts on the free disk adjacent to the locked vertebrae in motion between them, which otherwise generates the well-known phenomenon of "hinge effect" ", This time risking damage to the adjacent disk still in good condition.
Avec l'invention on va de plus créer une force de rappel sur les vis, force qui les ramène dans leur logement et évite ainsi les inconvénients des ciments consolidant en général utilisés avec les vis de l'art antérieur. De tels ciments posent des problèmes de température (nécessaire à une bonne polymérisation du ciment) et entraînent par ailleurs une impossibilité de ré intervention sur la vis une fois bloquée dans la masse.  With the invention we will also create a restoring force on the screws, force that brings them back into their housing and thus avoids the disadvantages of consolidating cements generally used with the screws of the prior art. Such cements pose temperature problems (necessary for good polymerization of the cement) and also cause an impossibility of re-intervention on the screw once locked in the mass.
Dans des modes de réalisation avantageux, on a par ailleurs et/ou de plus recours à l'une et/ou à l'autre des dispositions suivantes :  In advantageous embodiments, one or more of the following provisions are also and / or in addition:
- la tête de fixation de la pièce d' ancrage est solidaire d'une bague qui est munie des moyens de blocage ;  - The fastening head of the anchor is secured to a ring which is provided with locking means;
- la tête de fixation comprend un corps en forme de coupelle traversée latéralement par la tige perpendiculairement à la vis pédiculaire et munie d'un taraudage interne dans sa partie supérieure, de fixation de la tige par le biais d'une vis de compression, et la bague comprend un premier orifice traversant clipsable par déformation sur la périphérie supérieure de la tête de fixation, un deuxième orifice latéral traversant de passage de la bande et un troisième orifice d' insertion des moyens de blocage de la bande dans la bague ; the fixing head comprises a cup-shaped body traversed laterally by the rod perpendicular to the pedicle screw and provided with an internal thread in its upper part, fixing the rod by means of a compression screw, and the ring comprises a first through hole clipping by deformation on the upper periphery of the fixing head, a second lateral orifice; passing through the band and a third insertion hole means for locking the band in the ring;
- la tête de fixation comprend une partie supérieure cylindrique ou en portion cylindrique d'un premier diamètre, le premier orifice étant cylindrique de diamètre complémentaire au premier diamètre avec lequel il est agencé pour coopérer à frottement avant vissage de la vis de compression et avec lequel il est agencé pour se bloquer lors du serrage de ladite vis.  the fastening head comprises a cylindrical upper portion or a cylindrical portion of a first diameter, the first orifice being cylindrical with a diameter complementary to the first diameter with which it is arranged to cooperate with friction before screwing the compression screw and with which it is arranged to lock when tightening said screw.
Ce blocage provient de l'élargissement ou éloignement des parois du taraudage interne de la partie supérieure de la tête du fait de la compression exercée par la tête de la vis de compression elle-même sur ses bords.  This blockage comes from the widening or removal of the walls of the internal thread of the upper part of the head due to the compression exerted by the head of the compression screw itself on its edges.
Il en résulte par répercussion une compression de la paroi externe de tête sur la paroi interne du premier orifice et un blocage en conséquence en compression latérale ;  This results in repercussion a compression of the outer wall of the head on the inner wall of the first orifice and a consequent locking in lateral compression;
- la tête comprend une partie supérieure munie d'une gorge ou d'une nervure de rétention et le premier orifice traversant de la bague est muni d'une nervure ou d'une gorge de forme correspondante agencée pour être encastrée en force l'une dans l'autre ; - les moyens de blocage comprennent une pièce de maintien insérable dans le troisième orifice de la bague, la pièce de maintien étant au moins en partie en forme de coin écrasable, de blocage de la bande passant par le deuxième orifice ; the head comprises an upper part provided with a groove or a retaining rib and the first through-orifice of the ring is provided with a rib or a groove of corresponding shape arranged to be embedded in force; in the other ; - The locking means comprise a holding part insertable into the third hole of the ring, the holding part being at least partly in the form of crushable wedge, blocking the band passing through the second orifice;
la pièce de maintien présente une section transversale en forme de diapason dont les branches comprennent des dents extérieures anti-retour et dont le manche présente une extrémité arrondie, et le troisième orifice présente des parois latérales munies de dents anti-retour complémentaires de celle de la pièce de maintien et un fond de forme complémentaire à celle de l'extrémité du manche, de coincement de la bande entre les deux ;  the retaining piece has a tuning fork-shaped cross-section whose branches comprise external non-return teeth and whose handle has a rounded end, and the third orifice has lateral walls provided with non-return teeth complementary to that of the retaining piece and a bottom of complementary shape to that of the end of the handle, wedging the band between the two;
- la vis pédiculaire présente une extrémité ronde ou oblongue montée pivotante en rotation dans la partie inférieure de la tête et la tête comporte une structure de jonction entre la paroi cylindrique de la tige et ladite extrémité de vis.  - The pedicle screw has a round or oblong end rotatably mounted in rotation in the lower part of the head and the head comprises a connecting structure between the cylindrical wall of the rod and said screw end.
L'invention concerne aussi une pièce d'ancrage telle que décrite ci-dessus. Elle concerne également un procédé d' ancrage mettant en œuvre un système tel que décrit ci-dessus.  The invention also relates to an anchoring piece as described above. It also relates to an anchoring method implementing a system as described above.
Elle concerne de plus un procédé d'ancrage vertébral pour solidariser deux vertèbres adjacentes entre elles dans lequel on visse deux vis pédiculaires dans les pédicules en vis à vis d'une vertèbre, on glisse une tige au travers d'une tête de fixation de chaque vis sur ladite tige, et on visse une vis de pression sur la tige au travers de la partie supérieure de la tête, caractérisé en ce que avant de visser la vis de pression, on clipse sur la périphérie supérieure de chaque tête une bague comprenant un premier orifice traversant clipsable par déformation sur la dite périphérie supérieure et comprenant un deuxième orifice latéral traversant de passage d'une bande et un troisième orifice d' insertion de moyens de blocage de la bande sur ladite tête de fixation, on place la bande souple sur la vertèbre adjacente et dans les moyens de blocage de chaque tête de fixation, on bloque ladite bande sur une tête et on commence à mettre ladite bande souple en tension en tirant de l'autre côté, puis on met le tout en tension avant de bloquer définitivement la bande par rapport à la tête restante. It also relates to a vertebral anchoring method for securing two vertebrae adjacent to each other in which two pedicle screws are screwed into the pedicles opposite a vertebra, a rod is slipped through a fixing head of each screw on said rod, and screw a pressure screw on the rod through the upper part of the head, characterized in that before screwing on the pressure screw, a ring is clipped on the upper periphery of each head, comprising a first through hole which can be clipped by deformation on the said upper periphery and comprising a second lateral orifice through which a band passes through and a third orifice insertion of band locking means on said fixing head, placing the flexible band on the adjacent vertebra and in the locking means of each fixing head, blocking said band on a head and starting to put said band flexible in tension pulling the other side, then we put all the tension before definitively block the band relative to the remaining head.
On sécurise ainsi complètement mais avec douceur le mouvement de la vertèbre adjacente par rapport à celui de la vertèbre de base, en empêchant la flexion de l'une par rapport à l'autre, et ce dans le sens de fonctionnement de la colonne vertébrale.  This completely and gently secures the movement of the vertebra adjacent to that of the base vertebra, preventing the flexion of one relative to the other, and in the direction of operation of the spine.
L' invention sera mieux comprise à la lecture de la description qui suit de modes de réalisation donnés ci-après à titre d'exemples non limitatifs. La description se réfère aux dessins qui l'accompagnent dans lesquels :  The invention will be better understood on reading the following description of embodiments given below by way of non-limiting examples. The description refers to the accompanying drawings in which:
La figure 1 est une vue en perspective axionométrique d'une pièce d'ancrage selon un premier mode de réalisation de l'invention.  Figure 1 is an axionometric perspective view of an anchor according to a first embodiment of the invention.
La figure 1A est une vue en coupe selon IA - IA de la figure 1. La figure 1B est une vue en coupe selon IB - IB de la figure 1. FIG. 1A is a sectional view according to I A -I A of FIG. 1B is a sectional view according to I B - I B of Figure 1.
La figure 1C est une vue en coupe partielle du type de la coupe selon IB - IB, d'une variante de la pièce de la figure 1. FIG. 1C is a partial sectional view of the type of the section according to I B -I B , of a variant of the part of FIG.
La figure 2 est une vue en perspective de la bague de la pièce de la figure 1.  Figure 2 is a perspective view of the ring of the part of Figure 1.
La figure 3 illustre schématiquement en vue de dessus le système d'ancrage utilisant deux pièces d'ancrage selon la figure 1, deux tiges et la bande souple en tension autour de l'apophyse d'une vertèbre .  FIG. 3 schematically illustrates, in plan view, the anchoring system using two anchoring parts according to FIG. 1, two rods and the flexible band in tension around the apophysis of a vertebra.
La figure 4 est une vue en perspective d'un système comprenant deux pièces d' ancrage selon le mode de réalisation de l'invention plus particulièrement décrit ici, en position sur deux vertèbres adjacentes. A noter qu'on a ici fait figurer qu'une vis pédiculaire de fixation par tige, chaque tige devant bien entendu en comporter plusieurs pour bloquer les mouvements d'au moins deux vertèbres adjacentes.  Figure 4 is a perspective view of a system comprising two anchoring parts according to the embodiment of the invention more particularly described here, in position on two adjacent vertebrae. Note that it has been shown here that a pedicle fixation screw rod, each stem must of course include several to block the movement of at least two adjacent vertebrae.
La figure 1 montre une pièce d' ancrage 1 comportant une vis pédiculaire 2 propre à être vissée dans un pédicule de vertèbre (non représenté) .  Figure 1 shows an anchoring piece 1 comprising a pedicle screw 2 adapted to be screwed into a vertebra pedicle (not shown).
La pièce comporte une tête de fixation 3 sur une tige 4 solidaire de moyens 5 de blocage réglable d'une bande souple 6 en tension.  The part comprises a fixing head 3 on a rod 4 secured to means 5 of adjustable locking of a flexible band 6 in tension.
La bande 6 est plate par exemple en polyester tressé de 1 à 3 mm d'épaisseur et de 6 mm de large.  The strip 6 is flat, for example braided polyester 1 to 3 mm thick and 6 mm wide.
Les moyens 5 de blocage comprennent une bague 7 solidaire de la tête 3, qui comprend un corps 8 en forme de coupelle évidée percée en sa partie inférieure ou fond 9 pour laisser passer la vis pédiculaire 2, et comporte deux encoches latérales 10, ouvertes vers le haut, de passage latéral de la tige 4 qui vient s'y encastrer. The locking means 5 comprise a ring 7 integral with the head 3, which comprises a body 8 made of hollow cup shape pierced in its lower part or bottom 9 to let the pedicle screw 2, and has two lateral notches 10, open upwards, lateral passage of the rod 4 which is embedded therein.
Le corps 8 par exemple en titane, est cylindrique et comprend un fond arrondi et un évidement intérieur cylindrique 12 de passage et de blocage dans le sens axial de la vis.  The body 8, for example titanium, is cylindrical and comprises a rounded bottom and a cylindrical inner recess 12 for passage and locking in the axial direction of the screw.
Sa partie supérieure 13 comprend un taraudage interne 14 de fixation de la tige, introduite dans les encoches latérales 10, par une vis 15 de compression qui vient donc comprimer la tige sur la tête 16 de la vis pédiculaire 2.  Its upper part 13 comprises an internal tapping 14 for fixing the rod, introduced into the lateral notches 10, by a compression screw 15 which thus compresses the rod on the head 16 of the pedicle screw 2.
Celle-ci comprend un corps 17 de vissage muni d'un pas de vis connu en lui-même.  This comprises a screw body 17 provided with a screw thread known per se.
La tête 16 de la vis (cf. figure 1B) est munie d'une encoche 18 de vissage par un outil. Elle est partiellement sphérique et vient s'appuyer sur le fond 11 de la coupelle du corps 8 de la tête de fixation 3 avec qui elle coopère à frottement par rotation et en butée longitudinale.  The head 16 of the screw (see Figure 1B) is provided with a notch 18 for screwing by a tool. It is partially spherical and abuts on the bottom 11 of the cup of the body 8 of the attachment head 3 with which it cooperates with friction by rotation and in longitudinal stop.
Après vissage de la vis 2 préalablement introduite dans la pièce d'ancrage 1, et après introduction de la tige 4, on met en place la bague 7, et ce après introduction au-dessus de la tête de vis d'une pièce 19 de jonction/guidage/soutien en forme de demi- cylindre d'un côté (tige) et d'anneau de l'autre (tête de vis) .  After screwing the screw 2 previously introduced into the anchoring piece 1, and after introduction of the rod 4, is placed in place the ring 7, and this after introduction above the screw head of a piece 19 of junction / guide / support in the form of half cylinder on one side (rod) and ring on the other (screw head).
La bague 7 (cf. également figure 2) est une pièce par exemple en titane, de section transversale en forme de trou de serrure, avec une première portion 20 cylindrique et une seconde portion 21 parallélépipédique de plus petite largeur que le diamètre, ou sensiblement parallélépipédique. The ring 7 (see also FIG. 2) is a piece, for example made of titanium, of cross-section in keyhole shape, with a first cylindrical portion and a second parallelepipedal portion 21 of smaller width than the diameter, or substantially parallelepipedic.
La première portion 20 cylindrique (ou sensiblement cylindrique) est munie d'un alésage cylindrique interne 22 ou premier orifice comprenant une partie supérieure 23 rétrécie formant cornière de blocage en déplacement axial avec le dessus 24 de la tête de fixation.  The first cylindrical (or substantially cylindrical) portion is provided with an internal cylindrical bore 22 or first orifice comprising a narrowed upper portion 23 forming a locking angle in axial displacement with the top 24 of the fixing head.
L'alésage interne 22 coopère à frottement en contact cylindre/cylindre avec la surface externe de la partie supérieure cylindrique 13 du corps 8.  The internal bore 22 cooperates frictionally in cylinder / cylinder contact with the external surface of the cylindrical upper part 13 of the body 8.
Une fois la bague insérée sur cette partie supérieure en frottement, la vis 15 de serrage en compression est vissée.  Once the ring is inserted on this upper portion in friction, the compression clamping screw 15 is screwed.
De par ce vissage, la tête de la vis 15 étant conçue pour, on réalise une légère expansion du volume qu'elle occupe lors du serrage, par exemple de l'ordre de 0,2 mm, qui déforme en compression latérale l'alésage de l'attache, ce qui bloque tout mouvement de la bague par rapport à l'attache.  By this screwing, the head of the screw 15 being designed to, one carries out a slight expansion of the volume which it occupies during the tightening, for example of the order of 0.2 mm, which deforms in lateral compression the bore of the fastener, which blocks any movement of the ring relative to the fastener.
La figure 1C montre un autre mode de réalisation où le premier orifice 22 de la bague comprend une nervure encliquetée en force dans une rainure ou gorge correspondante.  FIG. 1C shows another embodiment where the first orifice 22 of the ring comprises a rib forcefully snapped into a corresponding groove or groove.
La bague 7 comprend un deuxième orifice 25, latéral, traversant, de passage de la bande 6 (en forme de fente verticale de largeur et épaisseur un peu plus grandes (par exemple avec un jeu de 1 mm) que celles de la bande 6 pour lui permettre son passage facile. The ring 7 comprises a second orifice 25, lateral, through, through the strip 6 (vertical slot-shaped width and thickness a little larger (for example with a clearance of 1 mm) than Band 6 to allow for easy passage.
La bague 7 comprend de plus un troisième orifice 26 traversant la portion 21 perpendiculairement par rapport au deuxième orifice 25. La portion 21 comprend une première partie 27 (cf. figure 1A) parallélépipédique comprenant des dents anti retour The ring 7 further comprises a third orifice 26 crossing the portion 21 perpendicular to the second orifice 25. The portion 21 comprises a first part 27 (see Figure 1A) parallelepiped including anti-return teeth
28 sur deux de ses faces latérales internes 29 en vis à vis (par exemple trois dents) , par exemple sur les faces latérales situées dans des plans parallèles à l'axe de la vis 2 et, de l'autre côté de l'orifice traversant 25 par rapport à cette première partie 27, une deuxième partie 30, parallélépipédique de plus petite largeur, mais de même hauteur que la première partie 27 d'orifice, par exemple débouchant sur la périphérie de la face externe 31 de la partie supérieure de la pièce de fixation 3. 28 on two of its internal lateral faces 29 opposite (for example three teeth), for example on the lateral faces located in planes parallel to the axis of the screw 2 and, on the other side of the orifice passing therethrough 25 with respect to this first portion 27, a second parallelepipedal portion 30 of smaller width, but of the same height as the first orifice portion 27, for example opening on the periphery of the outer face 31 of the upper portion of the fixing piece 3.
Les moyens 5 de blocage de la bande 6 comprennent par ailleurs une pièce de maintien 32 en forme de diapason dont les branches sont écrasables et/ou insérables en se déformant dans le troisième orifice 26.  The means 5 for blocking the band 6 furthermore comprise a retaining piece 32 in the form of a tuning fork whose branches are crushable and / or insertable while deforming in the third orifice 26.
Plus précisément la pièce 32 comprend une section transversale (cf. figure 1A) en forme de diapason comportant deux branches 33 et 34 séparées par un évidement 35, munies elles-mêmes, sur leurs faces extérieures en vis à vis des faces latérales internes More precisely, the piece 32 comprises a cross-section (see FIG. 1A) in the shape of a tuning fork having two branches 33 and 34 separated by a recess 35, themselves provided on their outer faces facing internal lateral faces.
29 de dents anti retour 36 complémentaires des dents 28 avec lesquelles elles vont s'encastrer par encliquetage progressif lorsque la pièce 32 est insérée en force dans la première partie 27. La pièce 32 comprend par ailleurs une langue en excroissance formant un manche 37 d'extrémité du diapason qui vient s'insérer dans la deuxième partie 30 de l'orifice pour venir coincer la bande 6 entre elle et les bords latéraux 38 et le fond 39 de ladite deuxième partie lorsque la pièce 32 est complètement encastrée dans le troisième orifice 26. 29 anti-return teeth 36 complementary teeth 28 with which they will fit by progressive snapping when the part 32 is inserted into force in the first part 27. The piece 32 also comprises a protruding tongue forming a handle 37 end of the tuning fork which is inserted into the second portion 30 of the orifice to come jam the strip 6 between it and the side edges 38 and the bottom 39 of said second part when the part 32 is completely embedded in the third orifice 26.
Pour ce faire un léger jeu va être laissé entre les parois du manche et celle de la deuxième partie d'orifice, pour permettre un écrasement suffisant de la bande et son blocage en position avec un dimensionnement calculé à la portée de l'homme du métier .  To do this a slight clearance will be left between the walls of the handle and that of the second portion of the orifice, to allow sufficient crushing of the band and its locking in position with a dimensioning calculated within the reach of the skilled person .
Les figures 3 et 4 illustrent le système d'ancrage selon le mode de réalisation de l'invention plus particulièrement décrit ici, utilisant deux pièces d'ancrage 1, l' dans les deux pédicules opposés 40 et 41 de la vertèbre 42, chaque pièce étant munie de vis 2, 2' et fixée sur les tiges 4, 4' par le biais des vis de compression 15, 15' .  FIGS. 3 and 4 illustrate the anchoring system according to the embodiment of the invention more particularly described here, using two anchoring pieces 1, 1 'in the two opposite pedicles 40 and 41 of the vertebra 42, each piece being provided with screws 2, 2 'and fixed on the rods 4, 4' by means of the compression screws 15, 15 '.
La bande 6 est bloquée de part et d' autre par les moyens 5, 5' de blocage et vient s'encastrer en 43 sur l'épiphyse 44 de la vertèbre 45 (cf. figure 4) .  The band 6 is blocked on both sides by the means 5, 5 'of locking and is embedded in 43 on the epiphysis 44 of the vertebra 45 (Figure 4).
On va maintenant décrire la mise en œuvre de l'ancrage avec le système selon le mode de réalisation de l'invention plus particulièrement décrit ici en faisant référence aux figures 1A et 4 .  We will now describe the implementation of the anchoring with the system according to the embodiment of the invention more particularly described here with reference to Figures 1A and 4.
Le chirurgien qui veut soulager le disque intervertébral 47 entre la vertèbre 42 (solide) et la vertèbre 45 (fragile) commence par fixer les vis pédiculaires préalablement munies de leur tête de fixation dans les pédicules 40 et 41 de la vertèbre 42, et ce de façon connue en elle-même, en vissant lesdites vis au travers des têtes, par le biais d'un tourne vis ou outil qui attaque l'encoche 18. The surgeon who wants to relieve the intervertebral disk 47 between the vertebra 42 (solid) and the vertebra 45 (fragile) begins by fixing the pedicle screws previously fitted with their head. fixation in the pedicles 40 and 41 of the vertebra 42, and this in a manner known per se, by screwing said screws through the heads, by means of a screw or tool that attacks the notch 18.
II vient ensuite encastrer les tiges 4, 4' sur les têtes, puis enclipser les bagues 7, 7' sur la périphérie supérieure de chaque tête.  It then fits the rods 4, 4 'on the heads, then snap the rings 7, 7' on the upper periphery of each head.
Préalablement ou ensuite, alors que les bagues conservent encore un certain degré de liberté en rotation par rapport à la tête de fixation correspondante, il glisse dans le troisième orifice, les portions d'extrémité respectivement 6' et 6'' de la bande 6.  Before or after, while the rings still retain a certain degree of freedom in rotation relative to the corresponding fixing head, it slides in the third orifice, the end portions 6 'and 6 "respectively of the strip 6.
Il vient alors placer la partie centrale 6' ' ' de la bande sur l'arête pinéale 44 de la vertèbre 45 adj acente .  He then comes to place the central portion 6 '' 'of the band on the pineal edge 44 of the adjoining vertebra 45.
Puis, d'une part il bloque la tête 3 sur la tige 4 en vissant la vis de compression 15 et d'autre part il bloque la portion d'extrémité 6' de la bande avec les moyens 8 de blocage, en insérant en totalité la pièce de maintien 32 dans le troisième orifice de la bague correspondante, les dents 28 de l'orifice coopérant en s' encastrant progressivement et par déformation puis reprise de leur emplacement dans les dents 36 du diapason, du fait de l'élasticité relative des branches dudit diapason.  Then, on the one hand it blocks the head 3 on the rod 4 by screwing the compression screw 15 and on the other hand it blocks the end portion 6 'of the band with the locking means 8, inserting in full the retaining piece 32 in the third hole of the corresponding ring, the teeth 28 of the cooperating hole gradually embedding and by deformation and then taken back from their position in the teeth 36 of the tuning fork, because of the relative elasticity of the branches of said tuning fork.
Les dimensions des éléments sont quant à elles conçues pour coincer la bande dans le recoin formé par la deuxième partie 30 du troisième orifice de façon inamovible et calculées de façon à la portée de l'homme du métier. Le chirurgien tend alors avec un outil de type connu la bande 6 en tirant sur la portion d'extrémité 6'' au travers des moyens de blocage 8' non encore contraint, la tête 3' de fixation ayant quant à elle été bloquée sur la tige 41 par vissage de la vis de compression 15' . The dimensions of the elements are designed to wedge the band in the recess formed by the second portion 30 of the third orifice irremovably and calculated to the scope of the skilled person. The surgeon then stretches the band 6 with a known type of tool by pulling on the end portion 6 '' through the still unrestrained blocking means 8 ', the fixation head 3' having, for its part, been locked onto the rod 41 by screwing the compression screw 15 '.
Puis une fois la tension sur l'arête 44 requise obtenue (par exemple par le biais d'un tenseur dynamométrique) l'extrémité 6'' est définitivement bloquée par rapport à la tête 3' .  Then once the voltage on the edge 44 required obtained (for example by means of a tensor dynamometer) the end 6 '' is permanently blocked relative to the head 3 '.
Comme il va de soi et comme il résulte également de ce qui précède, la présente invention n'est pas limitée aux modes de réalisation plus particulièrement décrits. Elle en embrasse au contraire toutes les variantes et notamment celles où les moyens de blocage sont différents, celles ou les vis pédiculaires sont à double filets ou encore celles ou 1 ' encliquetage des bagues sur la tête de fixation se fait par contact cône/cône, par exemple avec un angle de conicité du type cône morse et avec une languette de blocage déformable en partie inférieure .  As is obvious and as also follows from the above, the present invention is not limited to the embodiments more particularly described. On the contrary, it encompasses all the variants and in particular those in which the locking means are different, those where the pedicle screws are double-threaded or those where the rings are snapped onto the fixing head by means of cone / cone contact. for example with a taper angle of the Morse taper type and with a deformable locking tab at the bottom.

Claims

REVENDICATIONS
1. Système d'ancrage vertébral comprenant deux pièces d'ancrage (1) comportant chacune un élément pédiculaire (2) propre à être engagé dans un pédicule de vertèbre et reliées l'une à l'autre par un élément de liaison, caractérisé en ce que l'élément de liaison est une bande (6) souple, en ce que les éléments pédiculaires (2) sont des vis, en ce que chaque pièce d'ancrage (1) comporte une tête de fixation (3) sur une tige (4) solidaire de moyens (5) de blocage réglable de la bande souple en tension par rapport à la tête (3) et en ce qu'il comporte deux tiges (4, 4') correspondantes auxdites têtes de fixation. 1. A vertebral anchoring system comprising two anchoring pieces (1) each having a pedicle element (2) adapted to be engaged in a vertebral pedicle and connected to one another by a connecting element, characterized in that the connecting element is a flexible band (6), in that the pedicle elements (2) are screws, in that each anchoring piece (1) has a fixing head (3) on a rod (4) integral with means (5) of adjustable locking of the flexible band in tension relative to the head (3) and in that it comprises two rods (4, 4 ') corresponding to said fixing heads.
2. Système selon la revendication 1, caractérisé en ce que la tête de fixation (3) de la pièce d'ancrage 2. System according to claim 1, characterized in that the fastening head (3) of the anchor
(1) est solidaire d'une bague (7) qui est munie desdits moyens (5) de blocage. (1) is integral with a ring (7) which is provided with said means (5) for locking.
3. Système selon la revendication 2, caractérisé en ce que la tête de fixation (3) comprend un corps (8) en forme de coupelle traversée latéralement par la tige (4) perpendiculairement à la vis pédiculaire 3. System according to claim 2, characterized in that the fixing head (3) comprises a body (8) in the form of a cup traversed laterally by the rod (4) perpendicularly to the pedicle screw
(2) et muni d'un taraudage interne (14) dans sa partie supérieure (13), de fixation de la tige par le biais d'une vis (15) de compression, et en ce que la bague (7) comprend un premier orifice (22) traversant clipsable par déformation sur la périphérie supérieure (13) de la tête de fixation, un deuxième orifice (25) latéral traversant de passage de la bande (6) et un troisième orifice (26) d'insertion des moyens de blocage de la bande (6) dans la bague (7) . (2) and provided with an internal thread (14) in its upper part (13), fixing the rod by means of a screw (15) of compression, and in that the ring (7) comprises a first orifice (22) which can be clipped by deformation on the upper periphery (13) of the fixing head, a second lateral orifice (25) passing through the strip (6) and a third insertion orifice (26). locking means of the band (6) in the ring (7).
4. Système selon la revendication 3, caractérisé en ce que la tête de fixation (3) comprend une partie supérieure cylindrique ou en portion cylindrique d'un premier diamètre, le premier orifice (22) est cylindrique de diamètre complémentaire au premier diamètre avec lequel il est agencé pour coopérer à frottement avant vissage de la vis (15) de compression et avec lequel il est agencé pour se bloquer lors du serrage.  4. System according to claim 3, characterized in that the fixing head (3) comprises a cylindrical upper portion or cylindrical portion of a first diameter, the first orifice (22) is cylindrical with a diameter complementary to the first diameter with which it is arranged to cooperate frictionally before screwing the screw (15) of compression and with which it is arranged to lock during tightening.
5. Système selon la revendication 3, caractérisé en ce que la tête de fixation (3) comprend une partie supérieure munie d'une gorge ou d'une nervure de rétention et en ce que le premier orifice (22) traversant de la bague est muni d'une nervure ou d'une gorge de forme correspondante agencée pour être encastrée en force l'une dans l'autre.  5. System according to claim 3, characterized in that the fixing head (3) comprises an upper part provided with a groove or a retaining rib and in that the first orifice (22) passing through the ring is provided with a rib or groove of corresponding shape arranged to be embedded in force one in the other.
6. Système selon l'une quelconque des revendications 3 à 5, caractérisé en ce que les moyens (5) de blocage comprennent une pièce de maintien (32) insérable dans le troisième orifice (26) de la bague, la pièce de maintien étant au moins en partie en forme de coin écrasable, de blocage de la bande (6) passant par le deuxième orifice (25) .  6. System according to any one of claims 3 to 5, characterized in that the means (5) for locking comprises a holding piece (32) insertable in the third hole (26) of the ring, the holding part being at least partly in the form of crushable wedge, blocking the band (6) passing through the second orifice (25).
7. Système selon la revendication 6, caractérisé en ce que la pièce de maintien (32) présente une section transversale en forme de diapason dont les branches (33, 34) comprennent des dents (36) extérieures anti- retour et dont le manche (37) présente une extrémité arrondie, et en ce que le troisième orifice (26) présente des parois latérales munies de dents (28) anti-retour complémentaires de celles de la pièce de maintien (32) et un fond de forme complémentaire à celle de l'extrémité du manche, de coincement de la bande (6) entre les deux. 7. System according to claim 6, characterized in that the retaining piece (32) has a cross section in the form of a tuning fork whose branches (33, 34) comprise teeth (36) external anti-return and whose handle ( 37) has a rounded end, and in that the third port (26) has side walls provided with teeth (28) non-return complementary to those of the holding part (32) and a complementary shape of the bottom of the end of the handle, jamming the strip (6) between the two .
8. Système selon l'une quelconque des revendications précédentes, caractérisé en ce que la vis pédiculaire (2) présente une extrémité (16) ronde ou oblongue montée pivotante en rotation dans la partie inférieure de la tête de fixation et en ce que la tête de fixation comporte une structure (19) de jonction entre la paroi cylindrique de la tige et ladite extrémité de vis.  8. System according to any one of the preceding claims, characterized in that the pedicle screw (2) has a end (16) round or oblong rotatably mounted in rotation in the lower part of the fixing head and in that the head fastener comprises a structure (19) connecting the cylindrical wall of the rod and said screw end.
9. Procédé d'ancrage vertébral pour solidariser deux vertèbres (42, 45) adjacentes entre elles dans lequel on visse deux vis (2) pédiculaires dans les pédicules en vis à vis d'une vertèbre, on glisse une tige (4, 4') au travers d'une tête de fixation (3, 3' ) de chaque vis sur ladite tige, et on visse une vis (15) de pression sur la tige au travers de la partie supérieure de la tête, caractérisé en ce que on clipse sur la périphérie supérieure de chaque tête (3) une bague (7) comprenant un premier orifice (22) traversant clipsable par déformation sur la dite périphérie supérieure et comprenant un deuxième orifice latéral (25) traversant de passage d'une bande et un troisième orifice d'insertion de moyens (5) de blocage de la bande (6) sur ladite tête de fixation (3), on place la bande (6) souple sur la vertèbre adjacente (45) et dans les moyens (5) de blocage de chaque tête de fixation, on bloque ladite bande (6) sur une tête et on commence à mettre ladite bande souple en tension en tirant de l'autre côté, puis on met le tout en tension avant de bloquer définitivement la bande (6) par rapport à la tête restante. 9. A method of vertebral anchoring for joining two vertebrae (42, 45) adjacent to each other in which two pedicular screws (2) are screwed into the pedicles opposite a vertebra, a rod (4, 4 ') is slid ) through a fastening head (3, 3 ') of each screw on said rod, and a pressure screw (15) is screwed onto the rod through the upper part of the head, characterized in that clip on the upper periphery of each head (3) a ring (7) comprising a first orifice (22) traversable clipping by deformation on said upper periphery and comprising a second lateral orifice (25) passing through a strip and a third insertion hole means (5) for locking the band (6) on said fixing head (3), the flexible band (6) is placed on the adjacent vertebra (45) and in the means (5) of blocking each fixing head, blocking said band (6) on a head and we start to put said flexible band in tension by pulling the other side, then we put all the tension before definitively block the band (6) relative to the remaining head.
PCT/FR2016/050799 2015-04-17 2016-04-07 Vertebral fixation device WO2016166448A1 (en)

Priority Applications (9)

Application Number Priority Date Filing Date Title
EP16718436.5A EP3282980B1 (en) 2015-04-17 2016-04-07 Vertebral fixation device
CA2979956A CA2979956C (en) 2015-04-17 2016-04-07 Vertebral fixation device
ES16718436T ES2926581T3 (en) 2015-04-17 2016-04-07 Vertebral anchorage system and piece
AU2016250056A AU2016250056B2 (en) 2015-04-17 2016-04-07 Vertebral fixation device
KR1020177029183A KR102550609B1 (en) 2015-04-17 2016-04-07 vertebra fixation device
CN201680022270.XA CN107530113B (en) 2015-04-17 2016-04-07 Vertebral anchor system and components
JP2017554081A JP2018511433A (en) 2015-04-17 2016-04-07 Vertebral fixation device
US15/565,733 US10420590B2 (en) 2015-04-17 2016-04-07 Vertebral fixation device
HK18102840.8A HK1243301A1 (en) 2015-04-17 2018-02-27 Vertebral fixation device

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR1553424A FR3034978B1 (en) 2015-04-17 2015-04-17 SYSTEM, PART AND METHOD FOR VERTEBRAL ANCHORING.
FR1553424 2015-04-17

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WO2016166448A1 true WO2016166448A1 (en) 2016-10-20

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JP (1) JP2018511433A (en)
KR (1) KR102550609B1 (en)
CN (1) CN107530113B (en)
AU (1) AU2016250056B2 (en)
CA (1) CA2979956C (en)
ES (1) ES2926581T3 (en)
FR (1) FR3034978B1 (en)
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CN107530113B (en) 2020-02-28
JP2018511433A (en) 2018-04-26
AU2016250056A1 (en) 2017-10-05
EP3282980B1 (en) 2022-08-17
CN107530113A (en) 2018-01-02
ES2926581T3 (en) 2022-10-27
AU2016250056B2 (en) 2021-01-21
EP3282980A1 (en) 2018-02-21
US20180078286A1 (en) 2018-03-22
CA2979956A1 (en) 2016-10-20
KR20170138422A (en) 2017-12-15
KR102550609B1 (en) 2023-06-30
US10420590B2 (en) 2019-09-24
FR3034978B1 (en) 2017-04-07
FR3034978A1 (en) 2016-10-21
CA2979956C (en) 2023-08-22
HK1243301A1 (en) 2018-07-13

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